title: Routine clinical cardiovascular magnetic resonance in paediatric and adult congenital heart disease: patients, protocols, questions asked and contributions made.
abstract: BACKGROUND
  Cardiovascular magnetic resonance (CMR) of patients with congenital heart disease (CHD) has become routine clinical practice. However, existing CMR protocols focus predominantly on patients with ischemic heart disease, and information is limited on the types of patient with CHD who benefit from CMR investigation, and in what ways. Therefore the aim of this study was to answer the questions: What type of patients were studied by CMR in a centre specializing in paediatric and adult CHD management? What questions were asked, which protocols were used and were the questions successfully answered? To answer these questions, we conducted a cohort study of all 362 patients that received routine clinical CMR during 2007 at the Department of Paediatric Cardiology and Congenital Heart Disease at the Deutsches Herzzentrum München.
  
  
  RESULTS
  Underlying diagnosis was in 33% Fallot's tetralogy, 17% aortic coarctation, 8% Ebstein's disease, 6% Marfan's disease, 4% single ventricle with Fontan-like circulation, and 32% others. Median age was 26 years (7 days - 75 years). Ventricular volumes were assessed in 67% of the patients; flow in 74%; unknown anatomy only in 9%; specific individual morphology of known anatomy in 83%; myocardial fibrosis in 8%; stress-induced myocardial perfusion defects in 1%. Only in 3% of the cases the question could not be fully answered.
  
  
  CONCLUSIONS
  Contrary to common belief, routine CMR of patients with CHD was not requested to address global anatomical questions so much as to clarify specific questions of morphology and function of known anatomy. The CMR protocols used differed markedly from those widely used in patients with ischemic heart disease.
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Munich, Germany. fratz@dhm.mhn.de
authors.forename: Sohrab
authors.initials: S
authors.lastname: Fratz
authors.forename: John
authors.initials: J
authors.lastname: Hess
authors.forename: Annika
authors.initials: A
authors.lastname: Schuhbaeck
authors.forename: Christine
authors.initials: C
authors.lastname: Buchner
authors.forename: Eva
authors.initials: E
authors.lastname: Hendrich
authors.forename: Stefan
authors.initials: S
authors.lastname: Martinoff
authors.forename: Heiko
authors.initials: H
authors.lastname: Stern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D015331:Cohort Studies; D003326:Coronary Circulation; D005355:Fibrosis; D006330:Heart Defects, Congenital / Q000473:pathology* / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D018579:Patient Selection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult